%0 Journal Article %A Chad E Cook %A Steven Z George %A Michael P Reiman %T Red flag screening for low back pain: nothing to see here, move along: a narrative review %D 2018 %R 10.1136/bjsports-2017-098352 %J British Journal of Sports Medicine %P 493-496 %V 52 %N 8 %X Screening for red flags in individuals with low back pain (LBP) has been a historical hallmark of musculoskeletal management. Red flag screening is endorsed by most LBP clinical practice guidelines, despite a lack of support for their diagnostic capacity. We share four major reasons why red flag screening is not consistent with best practice in LBP management: (1) clinicians do not actually screen for red flags, they manage the findings; (2) red flag symptomology negates the utility of clinical findings; (3) the tests lack the negative likelihood ratio to serve as a screen; and (4) clinical practice guidelines do not include specific processes that aid decision-making. Based on these findings, we propose that clinicians consider: (1) the importance of watchful waiting; (2) the value-based care does not support clinical examination driven by red flag symptoms; and (3) the recognition that red flag symptoms may have a stronger relationship with prognosis than diagnosis. %U https://bjsm.bmj.com/content/bjsports/52/8/493.full.pdf